Thursday, August 20, 2009

Woke up at 3 AM with fuctional specs for the claims processing system for the Gov plan turning in my head. Visions of companies dumping employees into the Gov Plan and taking the 8% tax instead, claims rolling in for a yet to be defined benefits plan. Contracts being let to the Blues to process this whole mess. Congressionals rolling in..powerpoints for Congress to explain the blow ups and backlogs. 'Cause as the retired doc notes, all the details have yet to be written.

Everyone with any interest in the proposed health care legislation should go here to read DrRich's latest blog entry in which he tell us what the ambiguity in the house bill is really all about.

I have blogged briefly before on the ambiguity and cognitively impenetrable nature of HR 3200 and suggested that is was not due to ineptitude of the authors of the bill and their inability to clearly put in words what they were proposing. As DrRich points out it is ambiguous for a reason.

The reason is that the lack of meaning will be supplied by the rule making processes of the various government agencies and this will be an unending process as opposed to a one time rule setting.

Deliberate because there is no other way an overhaul this comprehensive can be spelled out in a law. It all falls on the shoulders of the nameless folks who draft the regs, and then implement the procedures.

The whole Health Care overhaul reeks of Chicago Way tactics. Bring the players in and cut the side deals. There were more deals made here for sure. This is just the tip. Nice to see the rest of the world finally awakening to the sorts America's sent to Washington.

August 11: Christiane Brown talks with Greg Palast on Air America Radio about POTUS’s backroom deal with Big Pharma. Wait for the money quote: “It makes me puke that we have just been ‘Cheneyed’ by a guy named Barack Obama.

Wednesday, August 19, 2009

Obama, Axelrod, Jarrett, and Rahm did Health Care reform the Chicago Way. Get the heavey hitters into a room: Phrama, AARP, AMA, HIA; make all the side deals, and then push the bill through without hearings or public review.

Springfield's ways gone to DC. Assume the Bosses and Regular Party Goodfellas will bring the voters along. Dress it up in Progressive lingo so the Lake Front Goo Goos and Hyde Parkers can sleep easy. That's the way we do it in Illinois.

Lashing out at the town hall protesters, playing the race card, whining about angry white men and whispering ominously about right-wing militias is almost always a sign of liberalism's weakness -- a failure of the imagination.

The left, broadly speaking, has been attacking conservative talk radio and all it allegedly represents for the better part of 20 years now. When Bill Clinton needed a convenient villain, he attacked Rush Limbaugh. When Bush emerged victorious from the Florida recount, liberals concluded that what they really needed was their own version of Limbaugh. Last March, at the first sign of resistance from congressional Republicans, Obama immediately complained that the GOP was Limbaugh's lap dog, and both the White House and much of the press corps went into anti-Limbaugh campaign mode.

It's funny how these supposed champions of the Enlightenment can't grasp that people can disagree with them for honest reasons. Instead, we simply must be Limbaugh's automatons, which is to say racist, fascist thugs.

In addition to the slander, such complaints are monumentally, incandescently lame coming from a party that controls Washington. Indeed, according to liberals themselves, these evil-mongers are a tiny minority, a bunch of "Astro Turf" frauds. So why not ignore them and get on with the work you were elected to do?

Well, because they can't -- or won't.

The wheels fall off Obama's Liberalism and the whole of Liberalism as we've known it comes to an end. Liberals sense that, repackage themselves as Progressives, yet there still stuck with can't and won't when it comes to getting anything done. It's a failure of imaginiation, a spent Liberalism.

Six months ago today, President Obama signed a stimulus bill with the promise that government spending would put Americans back to work. Congress was told that borrowing another $1 trillion would prevent unemployment from rising over 8% nationwide. With the loss of more than two million jobs since the stimulus was signed and unemployment at 9.4%, the results are in: the stimulus isn't working. This Administration and this Congress have failed to keep their promise to the American people.

The American people know we can't borrow and spend our way back to a growing economy. Thousands of Americans are filling town hall meetings expressing outrage and disappointment at the policies of a Congress and an Administration that promised to mend our economy and get people back to work, and that has only offered more spending, more deficits, more bailouts and more unemployment.

In the next six months, Democrats in Washington should start working with House Republicans on real solutions to get this economy back on track: fiscal discipline in Washington, D.C and fast-acting tax relief for working families and small businesses. The American people deserve solutions to put our nation back to work, not more empty promises from Washington, D.C.

On the six-month anniversary of the bloated, ineffective trillion-dollar "stimulus" becoming law, the American people are increasingly skeptical about the law that is – by any objective standard – not working. The latest evidence: a new USA Today/Gallup poll, which found that 57 percent of adults say the “stimulus” is having no impact on the economy or making it worse. The poll also found that 60 percent of Americans do not believe the “stimulus” will help the economy in the years ahead. With these latest numbers in mind, here are 10 critical facts that every American should know as the Washington Democrats continue to peddle their misguided, ineffective economic policies:

1. Despite the Administration’s promise that the “stimulus” would provide an immediate “jolt” to the economy and create jobs “immediately,” more than 2.8 million jobs have been lost since it was enacted on February 17, 2009.

2. On the day the “stimulus” was enacted, the national unemployment rate was 7.6 percent. Today it is 9.4 percent.

3. On May 13, Vice President Biden issued a report on the stimulus’ first 100 days asserting that it had “saved or created” 150,000 jobs, and that “an additional 600,000 jobs are expected to be created or saved under the Recovery Act in the next 100 days” for a total of 750,000 jobs. But the Bureau of Labor Statistics Commissioner told Congress earlier this year that it’s “very difficult for anyone to substantiate” the Administration’s claims – especially since Secretary Geithner recently said that unemployment won’t come down until late in 2010 and that the economy has shed 2.8 million jobs since February.

5. The number of long-term unemployed (those jobless for 27 weeks or more) is now five million, up from 2.6 million when the “stimulus” was signed into law.

6. Since the “stimulus” was enacted, Democrats have added $869 billion in new debt that will be paid for by our children and grandchildren.

7. A $255 million program using stimulus funds designed to help struggling small business by providing them with 10,000 loans of up to $35,000 each, has only given out 1,127 loans, totaling $36.8 million, according to the New York Times.

8. An analysis last week by the Washington Times found that stimulus money “spending has slowed to a trickle, despite President Obama’s June order to his Cabinet to speed it up. The average stimulus spending per week has dropped severely, to just $4.2 billion over the past month from $9.7 billion during the prior four months.”

9. According to the Associated Press, “Tens of thousands of unsafe or decaying bridges carrying 100 million drivers a day must wait for repairs because states are spending stimulus money on spans that are already in good shape or on easier projects like repaving roads.”

10. Stimulus funds are not getting to those areas that need it most, according to a detailed analysis by ProPublica that found that there’s “no relationship between where the money is going and unemployment and poverty” and that, “…spending is uneven and sometimes runs contrary to measures of need.”

Single Payor never got a fair hearing, or much of any kind of hearing, because the Democratic Congress chose not to hold any hearings. Medicare for all doesn't fly because Unions aren't about to give up cheap Cadillac Health Plans to participate in Medicare.

What's wrong with Healthy Americans Act and a tax credit for all? Break the employer based benefits system and make Health Insurance available to every individual American with a tax credit? Heading back to square one certainly makes sense. There is no salvaging HR3200.

CALL AND WRITE TODAYBack to Square oneMEDICARE FOR ALL!First Single-Payer doesn't even get a fair hearing, then the Public Option is off the table too?

CALL RIGHT NOW and KEEP CALLING UNTIL YOU GET THROUGH!!

The White House:

Phone: (202) 456-1111

This link will enable you to send a letter to the President.http://www.whitehouse.gov/contact/

Senator Dick Durbin

Phone: (202) 224-2152 Washington DC (312) 353-4952 Chicago

This link will enable you to send an email letter to Senator Durbin:http://durbin.senate.gov/contact.cfm

Senator Roland Burris

Phone: (202) 224-2854 Washington DC (312) 885-3506 Chicago

This link will enable you to send an email letter to Senator Burris:http://durbin.senate.gov/contact.cfm

Rep. Peter Roskam

Phone: (630) 893-9670 Bloomingdale (202) 225-4561 Washington DC

This link will enable you to send an email letter to Congressman Roskam:http://www.house.gov/formroskam/email.html

Rep. Judy Biggert

Phone: (630) 655-2052 Willowbrook (202) 225-3515 Washington DC

This link will enable you to send an email letter to Congressman Biggert.http://judybiggert.house.gov/ContactJudy.aspx

PLEASE WRITE TO info@dupagedemocrats.comafter you make your calls and give us a brief synopsis of your call!PAID FOR BY THE DEMOCRATIC PARTY OF DUPAGE COUNTY (630-629-1125)

The stimulus act included funding to pay providers for the Meaningful Use of Electronic Medical Records and the committee's task is to define just what Meaningful Use should mean. The Matrix is their start.

A lot of money rides on this. Note the 2015 Goals include Efficiency measures for both outpatient and inpatient care to-be-determined. How HHS plans to measure efficiency, and the fates of providers HHS finds inefficient should be fodder for hearings.

Mr. Blumenthal, Dr.Perlin, Dr. Halamka; just what do you folks have in mind here for efficient Health Care? It's vast powers the Stimulus Bill has granted to you. Your task deserves some careful attention from those of us who are going to be at the receiving end.

Here are the 2011 measures for a flavor of where they're headed and the cohorts soon to be subjected to 2015's efficiency metrics.

Friday, August 14, 2009

And the Surgeons respond. Never tangle with guys who like to start work at 5am.

Statement from the American College of Surgeons Regarding Recent Comments from President Obama

CHICAGO—The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President’s remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.

About the American College of SurgeonsThe American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world.

Part of Obama's problem is Chicago politicans don't give a hoot about policy, and ideas, and thoughfulness. They're all about getting deals. Lining up the players for a bill, getting the donations kicked in, divvying up the boodle and contracts. They bring Rahm's brother on to dress things up a bit but no body bothers to read the guy, because, well, in Chicago real players are dealers, not readers.

"This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citi- zens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with de-mentia."

Whoa... time to head to the public forum called the Chicago Regular Democratic Ward Organization office and commit to selling enough tickets for the Ward Committeemen's golf outing to get my name on the clout list for health care before I end up on Zeke's de-mentia list instead.

Thursday, August 13, 2009

Senator Durbin owes Illinois an apology here. It's a free country and we're all free to "orchestrate" but when your side's got hire help off Craig List, you ought to reconsider HR3200 you're pushing unto Americans.

Wednesday, August 12, 2009

Zeke Emanuel is Rahm Emanuel's brother and Pres Obama's Special Advisor for Health Policy and a guy I think Obama's choice for the US's first "Health Choices Commissioner" to be created under subtitle E of HR 3200. The graph is from a recent article in the British Medical Jouranal The Lancet titled Principles for allocation of scarce medical interventions (a PDF file).

The basic premise seems to be that since someone or some entity must allocate scare medical resources there should be a "morally" acceptable method for such allocation. The authors, which include Dr. Ezekiel J Emanuel, brother of President Obama's Chief of Staff, and "Special Advisor for Health Policy" to the president presents a detailed proposal of how this allocation should be done. (Using the passive voice here serves the purpose or not having to say that the government will do the allocation.)

The authors begin with a critical review of the currently in existence allocation systems and finding flaws in each proceed to devise their own "hybrid" supposedly salvaging the good and casting out the less desirable elements of the various systems.

Expectedly, this "morally acceptable" allocation process would allocate less to the elderly and those with incurable illnesses. Perhaps unexpectedly, their process would place, for example, a fifteen year person allocation-wise above an infant because they say more social expenditures have been made on the adolescent and society need to get its money's worth.

The underlying theme is that individuals exist for the good of the collective ( state, society, pick one) and in health care decisions the greater good of society, now apparently denominated in "life years", trump the individual every time.

Read Zeke, read Gaulte, then find your age on the graph and you won't need to think hard why seniors a bit angry.

Hubert Humphrey's Liberal's mantra was,

"It was once said that the moral test of Government is how that Government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped."

Look at that bulge in the graph for the young to receive the bulk of the car and wonder if HR3200 passes HHH's test?

It seems a total failure to me. A true Liberal (or Socialist) would build Hospitals and Clinics, educate more Doctors and Nurses; as the real way to build supply to meet peoples needs. Not slap price controls on the status quo of employer-based health and than ration the car to the young and productive in the name of the greater good.

PEOPLE suffering from mental health problems have to wait over a year for help in some parts of Scotland, a report released today has revealed.Audit Scotland said there was a lack of information on national waiting times but "very long waits" in some areas might reflect a wider trend.

The public spending watchdog also highlighted the long wait for services for younger and older people and the lack of out of hours and crisis care in some areas.

It found waits of between 58 and 77 weeks for psychological therapies in two areas covered by NHS Highland.

The Catholic Ladies find Foster's dropped is Town Hall meetings and seems to be staying put while his staff makes all the appearances. The women have a question for him and want us all to ask,

The Congress has been very active in this last session. I am certain that the citizens of this district would like a public airing of these recent events. In addition, we would like to know if Rep. Foster plans to waive his healthcare option and live with the same healthcare plan that Democratic Congress has just sentenced my family to. I am requesting a written response to this matter... not a debate on the merits of Socialism, not an outline of how much money will be saved, how the rich need to be punished, or how much smarter Rep. Foster is than I am. I want a specific answer to a specific question.

Seems a fair and sensible question to me. Not something from asked by some loons. Why hide?

Rep Doggett met with constituents outside a grocery store in south Austin regarding the health care bill. Apparently the event was mostly advertised in liberal leaning local publications. He did not bring a megaphone, so hearing what he had to say was difficult. When he started making the move to leave, the crowd erupted chanting "Just say no!" His worker got the car ready to shuttle him away but the crowd surrounded it and it took a while for him to get out of the parking lot. The whole time, the "Just say no!" chant continued. It probably won't matter - from his facial expression, body language, and what was heard to come out of his mouth, he's for the the health care bill in its present form and has no openness to change on that.

Please note that I was not chanting, I did not arrive in a bus, and I was not paid to be there. Neither was anyone else that I spoke with. I simply showed up to see what the congressman had to say. His resolve to vote his 'conscience' even if it goes against the desires of his constituents is not at all what our representative government is about.

[Ten thousand megapardons for the out of focus video - my camera body does not autofocus when shooting video and no shorter lens was handy to throw on the camera.]

Although skin cancer rates continue to rise in Canada, there is a severe shortage of dermatologists. In the Okanagan, just one dermatologist serves Kelowna and Vernon. Dr. Carmel Anderson‘s waiting list is six months long. She has stopped putting names on her cancellation list because that has too many names on it to make a cancellation appointment even remotely possible except for those at the top. The Canadian Dermatology Association said only between 600 and 700 dermatologists are available to treat the country‘s population of more than 30 million.

Read the whole thing. This is what price controls do too supply. In this case, the supply of Dermatologists. Americans wouldn't tolerate this.

"Reform has a tendency to put all but the biggest temperaments in a cocksure intellectual attitude -and that attitude puts one terribly out of harmony with the great underlying life forces. The gods take their revenge on the cocksure.